Related Experiment Video
Updated: Jul 3, 2026
Adult and Pediatric Porcine Model of Acute Volume Overload
Published on: January 12, 2024
Plasma volume replacement with HES 130/0.42 obviates negative side effects of pneumoperitoneum in piglets
Wilhelm Alexander Osthaus1, Dirk Huber, Christoph Bäumker
1Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Germany. osthaus.alexander@mh-hannover.de
Insights
Liberal plasma volume stabilization with colloids improved hemodynamics and acid-base balance in piglets undergoing prolonged pneumoperitoneum (PP). This fluid management strategy may be beneficial for infants during laparoscopic surgery.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Fluid Management
Background:
- Optimal perioperative fluid management guidelines for infants are lacking.
- Adult studies suggest large fluid volumes may increase morbidity; infant surgical experience differs.
- This study investigates fluid management during prolonged pneumoperitoneum (PP) in an infant model.
Purpose of the Study:
- To compare crystalloid versus plasma volume stabilizing fluid management during prolonged PP in piglets.
- To evaluate the impact of different fluid regimens on hemodynamic stability and acid-base balance.
Main Methods:
- Fifteen piglets were randomized into three groups: control, crystalloid, and colloid (hydroxyethyl starch).
- Prolonged pneumoperitoneum (PP) was induced for 180 minutes.
- Hemodynamics, transpulmonary thermodilution, and blood gases were monitored throughout and after PP.
Main Results:
- Mean arterial pressure and cardiac output decreased in the crystalloid group post-PP, unlike controls and colloid group.
- Lactate concentrations were higher and base excess lower in the crystalloid group at study end.
- Colloid administration maintained normal hemodynamics and acid-base balance.
Conclusions:
- Liberal plasma volume stabilization with colloids effectively obviates negative hemodynamic and acid-base effects of prolonged PP.
- Colloid-based fluid management may be superior to crystalloids in infants undergoing laparoscopic surgery with PP.
Background:
Evidence-based guidelines on optimal perioperative fluid management in infants have not been established. Recent randomized trials in major abdominal surgery in adults suggest that large volumes of fluid may increase morbidity and hospital stay. Our own clinical experience in infants undergoing laparoscopic surgery is different. So the aim of this study was to compare a crystalloid vs a plasma volume stabilizing fluid management regime during prolonged pneumoperitoneum (PP) in an experimental setting.
Methods:
Fifteen German landrace piglets were randomized to one of the following treatment groups: control (no PP, 5 ml x kg(-1) x h(-1) electrolyte solution); crystalloid (180 min of PP, 5 ml x kg(-1) x h(-1) electrolyte solution); colloid (180 min of PP, single bolus of 5 ml x kg(-1) followed by 5 ml x kg(-1) x h(-1) hydroxyethyl starch 130/0.42/6:2). After decompression, monitoring was continued for a further 120 min. During the investigation, the hemodynamic situation including transpulmonary thermodilution and blood gases was monitored periodically.
Results:
During the study, mean arterial pressure remained within the normal range in colloid-treated animals and controls, but was significantly lower in crystalloid-treated animals after decompression of PP. Cardiac output remained within the normal range in the colloid and control groups, but decreased in the crystalloid-treated animals. In the crystalloid group, the lactate concentrations were higher and base excess was lower than in the colloid and control groups at 240 and 300 min (study end).
Conclusion:
This study shows that the negative effects of prolonged PP on hemodynamics and acid-base balance can be obviated by a liberal plasma volume stabilization regimen with colloids.
